NHS needs health IT personnel

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TORONTO -- Managers of massive electronic health care projects being established worldwide face a global shortage of qualified professionals who understand both health care and information technology, said Richard Granger, director general of the United Kingdom's National Health Service (NHS) IT project.

Granger, who manages the 10-year, $10 billion-plus project to create an e-health records system for NHS and its 30,000 health care professionals, said he can't find enough skilled personnel who understand the complexity of clinical software systems and the process change it requires. He spoke today at the Canada e-Health 2005 conference.

E-health records systems can't be established until top executives and officials understand the changes required, said Louise Liang, senior vice president for quality and clinical systems support at Kaiser Permanente, the largest private health care provider in the United States.

"This is not an IT program," said Liang, who oversees Kaiser Permanente's 10-year, $3 billion project to deploy e-health records. "It's an executive change management project."

Kaiser Permanente covers 8.4 million patients served by 11,000 doctors. The company is deploying an e-health record system based on Epic Systems software.

Liang described her challenge as making sure end users are ready for the changes the new system requires. At a national level, she has almost 1,000 people working on her team, and cannot manage more, she said.

After hearing Liang speak, Granger joked that he could resolve his personnel shortages by raiding Kaiser.

Liang, Granger and Richard Alvarez, president of Canada Health Infoway, the Canadian agency charged with developing a pan-Canadian e-health records system all agreed that any health care system requires an investment equal to about 4 percent of annual health care revenues, a target both Kaiser Permanente and NHS are close to meeting.

Infoway has a capital budget of $957 million, which Alvarez said does not come close to the estimated $8 billion cost of a pan-Canadian e-health records system. But Infoway works with provincial governments who provide matching dollars for strategic investments, so the agency gets more bang for its limited bucks, Alvarez said.

Canada plans to have 50 percent of its population hooked up to an e-health records system by 2009, Alvarez said.

Although President Bush and other administration officials have spoken frequently about the need for e-health records, the investments by the United Kingdom, Canada Health Infoway and Kaiser Permanente greatly eclipse the United States' investment in such projects. The Department of Health and Human Services' 2005 budget includes $96 million for health care IT demonstration projects.

Granger took a shot at U.S. funding efforts, saying that although David Brailer, the U.S. national coordinator for health IT, has called e-health records systems disruptive, the relatively low level of U.S. federal funding ensures Brailer will face few disruptions.